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Anxiety, protective behaviors and related factors during the COVID-19 outbreak: A cross-sectional study

Year 2020, Volume: 4 Issue: 2, 186 - 192, 12.07.2020
https://doi.org/10.30565/medalanya.718083

Abstract

Aim: This study aims to determine the anxiety, personal protective behaviors, and related factors in Turkish society during the COVID-19 pandemic.

Patients and Methods: The sample consisted of 617 volunteer participants aged 18 to 75, living in the community and literate. Research approval, purpose, and questions were delivered to individuals in an online environment using a link and forms were collected by asking the participants to send back the completed questionnaires to the online environment. A COVID-19 data form and the State-Trait Anxiety Inventory (STAI-State) were used to collect the data.

Results: The study evaluated data from the 617 participants: 59.48% (n = 367) of the study participants were female and 40.52% (n = 250) were male. We found increased anxiety levels in the participants, with high levels of anxiety in 30.79% (n = 190). The main personal protective behavior was “washing hands frequently” (84.76%). Personal distance and mask usage rates were low (8.6% and 5.02%, respectively). We found higher anxiety levels in men (p = 0.008), people with chronic diseases (p = 0.003), the elderly (p<0.001) and those with lower education levels (p<0.001). We found higher levels of anxiety in those showing avoidance behaviors.

Conclusions: The results of our study show that psychological consequences should be considered in addition to the physical outcomes of the COVID-19 outbreak and that some subgroups have a higher risk of anxiety. People who require professional support should be identified and psychological support should be planned.

References

  • 1. Cui J, Li F, Shi Z-L. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181–92. doi: 10.1038/s41579-018-0118-9
  • 2. Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health—The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264–6. doi: 10.1016/j.ijid.2020.01.009
  • 3. Paules CI, Marston HD, Fauci AS. Coronavirus infections—more than just the common cold. Jama. 2020;323(8):707–8. doi:10.1001/jama.2020.0757
  • 4. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536–44. doi: 10.1038/s41564-020-0695-z
  • 5. Organization WH. Coronavirus disease (COVID-19) outbreak. URL https//www who int/emergencies/diseases/novel-coronavirus-2019. 2020; (accessed Apr 2, 2020)
  • 6. Lee AM, Wong JGWS, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007;52(4):233–40. doi: 10.1177/070674370705200405
  • 7. Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cognit Ther Res. 2012;36(3):210–8. doi: 10.1007/s10608-011-9353-3
  • 8. Jones JH, Salathé M. Early assessment of anxiety and behavioral response to novel swine-origin influenza a(H1N1). PLoS One. 2009;4(12):2–9. doi: 10.1371/journal.pone.0008032.
  • 9. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5). doi: 10.3390/ijerph17051729.
  • 10. Shultz JM, Althouse BM, Baingana F, Cooper JL, Espinola M, Greene MC, et al. Fear factor: The unseen perils of the Ebola outbreak. Bull At Sci [Internet]. 2016;72(5):304–10. Available from: doi: 10.1080/00963402.2016.1216515
  • 11. Lesho E. The Politics of Fear: Médecins Sans Frontières and the West African Ebola Epidemic. Vol. 66, Clinical Infectious Diseases. 2018. 643–644 p. doi: 10.1093/cid/cix875
  • 12. Tang CS, Wong C. Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong. Prev Med (Baltim). 2004;39(6):1187–93. doi: 10.1016/j.ypmed.2004.04.032
  • 13. Lau JTF, Kim JH, Tsui HY, Griffiths S. Anticipated and current preventive behaviors in response to an anticipated human-to-human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infect Dis. 2007;7(1):18. doi: 10.1186/1471-2334-7-18
  • 14. De Zwart O, Veldhuijzen IK, Elam G, Aro AR, Abraham T, Bishop GD, et al. Perceived threat, risk perception, and efficacy beliefs related to SARS and other (emerging) infectious diseases: Results of an international survey. Int J Behav Med. 2009;16(1):30–40. doi: 10.1007/s12529-008-9008-2
  • 15. Vartti A-M, Oenema A, Schreck M, Uutela A, de Zwart O, Brug J, et al. SARS knowledge, perceptions, and behaviors: a comparison between Finns and the Dutch during the SARS Outbreak in 2003. Int J Behav Med. 2009;16(1):41. doi: 10.1007/s12529-008-9004-6
  • 16. Lau JTF, Griffiths S, Choi KC, Tsui HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. 2010; https://doi.org/10.1186/1471-2334-10-139
  • 17. Öner N, LeCompte WA. Durumluk-sürekli kaygı envanteri el kitabı. Boğaziçi Üniversitesi Yayınları; 1985.
  • 18. Ercan I, Hafizoglu S, Ozkaya G, Kirli S, Yalcintas E, Akaya C. Examining cut-off values for the state-trait anxiety inventory. Rev Argentina Clin Psicol. 2015;24(2):143–8.
  • 19. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry [Internet]. 2020;33(2):e100213. doi: 10.1136/gpsych-2020-100213
  • 20. Rubin GJ, Amlôt R, Page L, Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. Bmj. 2009;339:b2651. doi: 10.1136/bmj.b2651
  • 21. Sareen J, Erickson J, Medved MI, Asmundson GJG, Enns MW, Stein M, et al. Risk factors for post‐injury mental health problems. Depress Anxiety. 2013;30(4):321–7. doi: 10.1002/da.22077
  • 22. Leung GM, Ho L-M, Chan SKK, Ho S-Y, Bacon-Shone J, Choy RYL, et al. Longitudinal Assessment of Community Psychobehavioral Responses During and After the 2003 Outbreak of Severe Acute Respiratory Syndrome in Hong Kong. Clin Infect Dis. 2005;40(12):1713–20. doi: 10.1086/429923
  • 23. Blakey SM, Abramowitz JS. Psychological Predictors of Health Anxiety in Response to the Zika Virus. J Clin Psychol Med Settings [Internet]. 2017;24(3–4):270–8. doi: 10.1007/s10880-017-9514-y
  • 24. Rubin GJ, Amlôt R, Page L, Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. BMJ 2009;339:b2651. doi: 10.1136/bmj.b2651
  • 25. Gaygisiz Ü, Gaygisiz E, özkan T, Lajunen T. Individual differences in behavioral reactions to H1N1 during a later stage of the epidemic. J Infect Public Health [Internet]. 2012;5(1):9–21. Available from: doi: 10.1016/j.jiph.2011.09.008

COVID-19 Salgını Sırasında Anksiyete, Koruyucu Davranışlar ve İlişkili Faktörler: Kesitsel Bir Çalışma

Year 2020, Volume: 4 Issue: 2, 186 - 192, 12.07.2020
https://doi.org/10.30565/medalanya.718083

Abstract

Amaç: Bu çalışmada COVİD-19 pandemisi sırasında Türk toplumunda anksiyete, kişisel koruyucu davranışlar ve ilişkili faktörleri incelemeyi amaçlanmıştır.

Hastalar ve Yöntem: Örneklemimizi 18-75 yaş arası, okur-yazar, çalışmaya gönüllü 617 birey oluşturmuştur. Araştırma onamı, amacı ve sorular soft ortamda bireylere bir link vasıtasıyla ulaştırılmış ve formlar yine soft ortamda cevaplanan anketlerin iletilmesiyle toplanmıştır. Verilerin toplanmasında, araştırmacılar tarafından oluşturulan COVİD-19 ile ilgili soruları ve sosyo-demografik verileri içeren form ve Durumluk-Sürekli Kaygı Envanteri (STAI-Durumluk) kullanıldı.

Bulgular: Çalışmada 617 gönülle değerlendirilmiştir. Çalışmaya katılanların %59.48 (367)’i kadın, %40.52 (250)’si erkekti. Katılımcıların % 30.79 (190)‘unda yüksek seviyede kaygı düzeyleri saptanmıştır. Başlıca gerçekleştirilen kişisel koruyucu davranış yüksek oranda elleri sık sık yıkama şeklindedir. (%84.76). İkinci sıklıkta ise insanlarla en az bir metre mesafe koyma davranışıdır. (%8.6). Katılımcıların %5.02 (31)’i maske takmakta, %1.62 (10) kişi ise hiçbir koruyucu önlem almamaktadır. Çalışmada erkeklerde (p=0.008), tanılanmış kronik hastalığı olanlarda (p=0.003), yaşlılarda (p<0.001) ve daha düşük eğitim düzeyi olanlarda (p<0.001) daha yüksek kaygı düzeyleri saptanmıştır. Kişisel koruyucu davranışlardan kaçınıcı davranış yüksek kaygı düzeyi ile ilişkili bulunmuştur. 

Sonuç: Çalışmamızın sonuçları, COVID-19 salgınının fiziksel sonuçlarına ek olarak, psikolojik sonuçların da dikkate alınması gerektiğini göstermektedir. Çalışmamızda bazı alt gruplarda kaygı riski daha yüksek belirlenmiştir. Profesyonel desteğe ihtiyaç duyan insanlar tanımlanmalı ve psikolojik destek planlanmalıdır.

References

  • 1. Cui J, Li F, Shi Z-L. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181–92. doi: 10.1038/s41579-018-0118-9
  • 2. Hui DS, I Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health—The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis. 2020;91:264–6. doi: 10.1016/j.ijid.2020.01.009
  • 3. Paules CI, Marston HD, Fauci AS. Coronavirus infections—more than just the common cold. Jama. 2020;323(8):707–8. doi:10.1001/jama.2020.0757
  • 4. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5(4):536–44. doi: 10.1038/s41564-020-0695-z
  • 5. Organization WH. Coronavirus disease (COVID-19) outbreak. URL https//www who int/emergencies/diseases/novel-coronavirus-2019. 2020; (accessed Apr 2, 2020)
  • 6. Lee AM, Wong JGWS, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007;52(4):233–40. doi: 10.1177/070674370705200405
  • 7. Wheaton MG, Abramowitz JS, Berman NC, Fabricant LE, Olatunji BO. Psychological predictors of anxiety in response to the H1N1 (swine flu) pandemic. Cognit Ther Res. 2012;36(3):210–8. doi: 10.1007/s10608-011-9353-3
  • 8. Jones JH, Salathé M. Early assessment of anxiety and behavioral response to novel swine-origin influenza a(H1N1). PLoS One. 2009;4(12):2–9. doi: 10.1371/journal.pone.0008032.
  • 9. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5). doi: 10.3390/ijerph17051729.
  • 10. Shultz JM, Althouse BM, Baingana F, Cooper JL, Espinola M, Greene MC, et al. Fear factor: The unseen perils of the Ebola outbreak. Bull At Sci [Internet]. 2016;72(5):304–10. Available from: doi: 10.1080/00963402.2016.1216515
  • 11. Lesho E. The Politics of Fear: Médecins Sans Frontières and the West African Ebola Epidemic. Vol. 66, Clinical Infectious Diseases. 2018. 643–644 p. doi: 10.1093/cid/cix875
  • 12. Tang CS, Wong C. Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong. Prev Med (Baltim). 2004;39(6):1187–93. doi: 10.1016/j.ypmed.2004.04.032
  • 13. Lau JTF, Kim JH, Tsui HY, Griffiths S. Anticipated and current preventive behaviors in response to an anticipated human-to-human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infect Dis. 2007;7(1):18. doi: 10.1186/1471-2334-7-18
  • 14. De Zwart O, Veldhuijzen IK, Elam G, Aro AR, Abraham T, Bishop GD, et al. Perceived threat, risk perception, and efficacy beliefs related to SARS and other (emerging) infectious diseases: Results of an international survey. Int J Behav Med. 2009;16(1):30–40. doi: 10.1007/s12529-008-9008-2
  • 15. Vartti A-M, Oenema A, Schreck M, Uutela A, de Zwart O, Brug J, et al. SARS knowledge, perceptions, and behaviors: a comparison between Finns and the Dutch during the SARS Outbreak in 2003. Int J Behav Med. 2009;16(1):41. doi: 10.1007/s12529-008-9004-6
  • 16. Lau JTF, Griffiths S, Choi KC, Tsui HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. 2010; https://doi.org/10.1186/1471-2334-10-139
  • 17. Öner N, LeCompte WA. Durumluk-sürekli kaygı envanteri el kitabı. Boğaziçi Üniversitesi Yayınları; 1985.
  • 18. Ercan I, Hafizoglu S, Ozkaya G, Kirli S, Yalcintas E, Akaya C. Examining cut-off values for the state-trait anxiety inventory. Rev Argentina Clin Psicol. 2015;24(2):143–8.
  • 19. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry [Internet]. 2020;33(2):e100213. doi: 10.1136/gpsych-2020-100213
  • 20. Rubin GJ, Amlôt R, Page L, Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. Bmj. 2009;339:b2651. doi: 10.1136/bmj.b2651
  • 21. Sareen J, Erickson J, Medved MI, Asmundson GJG, Enns MW, Stein M, et al. Risk factors for post‐injury mental health problems. Depress Anxiety. 2013;30(4):321–7. doi: 10.1002/da.22077
  • 22. Leung GM, Ho L-M, Chan SKK, Ho S-Y, Bacon-Shone J, Choy RYL, et al. Longitudinal Assessment of Community Psychobehavioral Responses During and After the 2003 Outbreak of Severe Acute Respiratory Syndrome in Hong Kong. Clin Infect Dis. 2005;40(12):1713–20. doi: 10.1086/429923
  • 23. Blakey SM, Abramowitz JS. Psychological Predictors of Health Anxiety in Response to the Zika Virus. J Clin Psychol Med Settings [Internet]. 2017;24(3–4):270–8. doi: 10.1007/s10880-017-9514-y
  • 24. Rubin GJ, Amlôt R, Page L, Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. BMJ 2009;339:b2651. doi: 10.1136/bmj.b2651
  • 25. Gaygisiz Ü, Gaygisiz E, özkan T, Lajunen T. Individual differences in behavioral reactions to H1N1 during a later stage of the epidemic. J Infect Public Health [Internet]. 2012;5(1):9–21. Available from: doi: 10.1016/j.jiph.2011.09.008
There are 25 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Tacettin Kuru 0000-0002-0313-558X

Pelin Uymaz 0000-0002-3535-6141

Publication Date July 12, 2020
Submission Date April 10, 2020
Acceptance Date June 6, 2020
Published in Issue Year 2020 Volume: 4 Issue: 2

Cite

Vancouver Kuru T, Uymaz P. Anxiety, protective behaviors and related factors during the COVID-19 outbreak: A cross-sectional study. Acta Med. Alanya. 2020;4(2):186-92.

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